Amano Hoichi, Fujimoto Kenichi, Fujimori Makoto, Saka Natsumi, Nomura Kyoko, Tanihara Shinichi
Graduate School of Public Health, Teikyo University, Itabashi-ku, Tokyo 173-8605, Japan.
Department of Social and Behavioral Sciences, Harvard. T.H. Chan School of Public Health, Boston, MA 02115, USA.
Acta Med Okayama. 2020 Feb;74(1):41-48. doi: 10.18926/AMO/57951.
We aimed to clarify the prevalence of polypharmacy among elderly individuals in Japan. We used the data obtained from a large-scale population-based representative database of health insurance claims in a single prefecture in Japan. We examined all of the outpatient and pharmaceutical health insurance claims for National Health Insurance and those for Late-stage Elderly Health Insurance in Nagasaki Prefecture, Japan between April and June 2016. When two or more claim forms were issued for a patient in a single month, we combined the data and identified the number of prescribed drugs for each person. The definition of polypharmacy is a the prescription of six or more drugs per month. We investigated the prevalence of polypharmacy among the beneficiaries of the two insurance systems. Of the 605,406 beneficiaries of the 2 insurance systems, 121,033 (20.0%) patients with polypharmacy were identified. The prevalence of polypharmacy increased with age, especially among the beneficiaries aged > 85 years, with about half of the beneficiaries having polypharmacy status. About half of the people aged > 85 years in the database had polypharmacy status. When a drug is prescribed to an elderly individual, it is necessary to consider the possibility of polypharmacy-related problems.
我们旨在阐明日本老年人中多重用药的流行情况。我们使用了从日本一个县的大规模基于人群的医疗保险索赔代表性数据库中获取的数据。我们调查了2016年4月至6月期间日本长崎县国民健康保险和后期老年人健康保险的所有门诊和药品医疗保险索赔。当一个月内为一名患者开具两份或更多索赔表时，我们合并数据并确定每个人的处方药数量。多重用药的定义是每月开具六种或更多药物的处方。我们调查了这两种保险系统受益人群中多重用药的流行情况。在这两种保险系统的605,406名受益人中，确定了121,033名（20.0%）患有多重用药的患者。多重用药的流行率随年龄增长而增加，尤其是在85岁以上的受益人中，约一半的受益人处于多重用药状态。数据库中85岁以上的人群中约有一半处于多重用药状态。当给老年人开处方时，有必要考虑多重用药相关问题的可能性。
